Nursing Elites

1. A client with a history of alcohol use disorder is admitted to the hospital for detoxification. Which of the following symptoms should the nurse expect to observe during withdrawal? Select one that doesn't apply.

• A. Tremors
• B. Hallucinations
• C. Diaphoresis
• D. Bradycardia

Correct answer: D

Rationale: During alcohol withdrawal, symptoms such as tremors, hallucinations, diaphoresis, and seizures are commonly observed. Bradycardia is not typically associated with alcohol withdrawal; instead, tachycardia, an increased heart rate, is more commonly seen. Therefore, bradycardia is the correct answer as it is not an expected symptom during alcohol withdrawal. Tremors, hallucinations, and diaphoresis are all common manifestations of alcohol withdrawal, while bradycardia is not typically seen in this context.

2. Which response demonstrates accurate information that should be discussed with the female patient diagnosed with bipolar disorder and her support system? Select the incorrect one.

• A. Remember that alcohol and caffeine can trigger a relapse of your symptoms.
• B. Due to the risk of a manic episode, antidepressant therapy is never used with bipolar disorder.
• C. It's critical to inform your healthcare provider immediately if you are experiencing sleep disturbances.
• D. Is your family prepared to be actively involved in helping manage this disorder?

Correct answer: B

Rationale: In managing bipolar disorder, it is vital to educate the patient and their support system about triggers like alcohol and caffeine, the significance of good sleep, and the need for family involvement. However, the statement in choice B is incorrect. While antidepressants need to be carefully monitored in bipolar disorder, they can be used in conjunction with mood stabilizers to manage depression in some cases.

3. A patient with schizophrenia is experiencing hallucinations. Which intervention is most appropriate?

• A. Encourage the patient to ignore the voices.
• B. Engage the patient in a reality-based activity.
• C. Provide a quiet environment to reduce stimulation.
• D. Ask the patient to describe the hallucinations in detail.

Correct answer: B

Rationale: Engaging the patient in a reality-based activity is the most appropriate intervention for a patient with schizophrenia experiencing hallucinations. This intervention can help distract the patient from the hallucinations and reorient them to the present, promoting a connection with reality and potentially reducing distress associated with the hallucinations. Choice A, encouraging the patient to ignore the voices, may not be effective as it can be challenging for the patient to dismiss the hallucinations. Choice C, providing a quiet environment, is helpful but may not directly address the hallucinations. Choice D, asking the patient to describe the hallucinations in detail, may increase the patient's focus on the hallucinations, potentially worsening distress.

4. In treating a patient with generalized anxiety disorder (GAD) using cognitive-behavioral therapy (CBT), what is the most appropriate goal of this therapy?

• A. To explore the patient's childhood experiences.
• B. To reduce the patient's symptoms through medication.
• C. To change the patient's negative thought patterns.
• D. To improve the patient's social skills.

Correct answer: C

Rationale: The most appropriate goal of cognitive-behavioral therapy (CBT) in treating generalized anxiety disorder (GAD) is to change the patient's negative thought patterns. This therapy focuses on identifying and modifying distorted thinking patterns that contribute to anxiety. Exploring childhood experiences (Choice A) may be part of therapy, but the primary focus is on present thoughts and behaviors. While medication (Choice B) can help manage symptoms, CBT aims to address the root cause through cognitive restructuring. Improving social skills (Choice D) is not the primary goal of CBT for GAD, although it may be a secondary benefit as confidence improves with reduced anxiety.

5. When developing a care plan for a client with generalized anxiety disorder (GAD), which of the following interventions should not be included?

• A. Encourage the client to avoid anxiety-provoking situations.
• B. Teach the client relaxation techniques.
• C. Encourage the client to express their feelings.
• D. Provide a structured daily routine.

Correct answer: A

Rationale: Avoiding anxiety-provoking situations is not a recommended intervention in caring for a client with generalized anxiety disorder (GAD) as it can reinforce the client's anxiety. Exposing the client gradually to feared situations can help reduce anxiety in the long term through techniques like cognitive-behavioral therapy. Teaching relaxation techniques helps the client manage stress and anxiety effectively. Encouraging the client to express their feelings promotes emotional processing and reduces internal tension. Providing a structured daily routine can offer predictability and stability, which are beneficial for individuals with GAD.

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